Compression hose, compression pants and accompanying compression pad

ABSTRACT

A compression device for exerting pressure on an arm, shoulder, and/or trunk of a patient in need thereof (for example, a patient with hyperalgia or recovering from surgery in which the lymphatic system is affected), including an arm compression hose, a shoulder part for exerting pressure on the shoulder and trunk area, and a band-shaped fastening means for positioning the shoulder part and exerting pressure on the shoulder part. The arm compression hose exerts a pressure that decreases from a maximum pressure at the wrist or hand to a minimum pressure near the shoulder end of the arm, where the minimum pressure is approximately 70% of the maximum pressure. One or more lining pockets can be constructed on the inner lining of the compression device, where each lining pocket can hold one or more compression pads to increase tissue pressure in one or more body areas in need thereof. The compression pads each can have a shape that approximately conforms to the shape of the body part to which it is applied. The shoulder part can also have a shape that approximately conforms to the contour of the shoulder/trunk area to which it is applied. In addition, compression pants can be prepared with lining pockets for receiving compression pads. In one embodiment, compression pants include one or more donut-shaped pads or equivalents thereof that are placed in one or more lining pockets, each of which surrounds one or more osteoma openings.

1. TECHNICAL FIELD

The present invention relates to a compression hose of elastic materialfor exerting tissue pressure on an arm of a patient, in which thecompression hose comprises a shoulder part which partially covers theshoulder joint when in use, while fastening means for fastening thecompression hose are provided on the shoulder part.

Such a compression hose is known in practice and is generally used tocounteract oedema formation in an arm in an oedematous patient. For thispurpose, the elastic material of the arm part has a predeterminedcompression value. The known compression hose is provided with a narrowshoulder part which is approximately 8 to 10 cm wide and serves tofasten a band of elastic material by means of which the compressionhose, is fastened to the trunk of the patient.

The object of the compression hose according to the present invention,is to solve very specific and commonly occurring problems in aparticular group of oncology patients to which until now, no solutionhad been found.

2. BACKGROUND ART

Surgery and radiotherapy are generally used in the treatment of cancer.In many cases a large part of the lymph nodes is removed from lymphareas situated near the tumour(s).

As a result of damage to the primary lymph drainage channels, forexample, as may result from surgery and radiation treatment, a reducedlymph transportation capacity can occur in this case in the areasconcerned, which produces so-called “relative lymphostasis”, or theclinical oedema-free stage. In this stage, pathological changes, such asaccumulations of fibrinoid material, already occur in the tissue. Inlymphostasis or its manifestation—oedema—we see accumulations of plasmaproteins in the tissue. Both in relative lymphostasis and inlymphostasis, these plasma proteins are responsible for the inflammatorystimulation which maintains a non-specific inflammatory reaction in thetissue, which is a characteristic tissue reaction in relativelymphostasis and lymphostasis.

On account of the above, the pain symptoms experienced post-operativelyby oncology patients who have undergone mainly axillary and inguinallymph gland dissection can be defined as chronic lymph circulationdisturbances in which primarily painful congestion and inflammationoccur, so-called hyperalgesia.

Hyperalgesia in the operated hemithorax (the half of the trunk) and thecorresponding arm or in the operated lower half of the trunk and thecorresponding leg generally occurs in the clinical oedema-free stage,both in intermittent reversible oedema and in slight to moderate oedema.

More severe forms of hyperalgesia occur in the case of malignant lymphoedema and with the occurrence of acute radiation reactions duringradiation treatment. In an acute radiation reaction, due to hyperaemiacaused by the heat effect, increased permeability of the capillary bloodvessels to plasma proteins occurs. At the point where a painfulprotein-rich swelling already existed after the operation, a severe formof hyperalgesia occurs in the form of a stinging, burning feeling. Inthis context we could mention seroma formation, haematoma formation,infiltration, slow-healing wounds, infection and in general allsituations in which post-operatively an increased concentration ofplasma proteins is already present in the tissue.

The above symptoms are of a subchronic to chronic nature and can bereadily overcome in particular following the use of manual lymphdrainage (MLD). Manual lymph drainage is a special form of non-forcingmassage. Manual lymph drainage promotes the reabsorption of(protein-rich) tissue fluid in blood and lymph capillaries andstimulates the motor function of the lymph vessels, with the result thatthe lymph transportation capacity increases and the symptoms decline ordisappear. (Relative) lymphostasis in the abovementioned areas isprevented or relieved here by increasing the tissue pressure from theoutside.

The aetiology, pathogenesis and treatment of hyperalgesia, in this caseby manual lymph drainage and compression therapy, constitutes anentirely new area within lymphology.

3. DISCLOSURE OF THE INVENTION

The object of the invention is to overcome the abovementioned problemsand indicate a solution by which the beneficial effects of manual lymphdrainage in the supraclavicular area, the armpit folds front and back,the shoulder area and/or the cranial trunk areas (anterior andposterior) in a patient are consolidated and/or increased.

This is achieved in the case of a compression hose according to theinvention through the fact that the shoulder part is lengthened in sucha way that when in use it extends past the h-line running verticallyfrom the armpit to the shoulder line, and through the fact that theshoulder part is widened in such a way that when in use it covers atleast an area on the trunk, which is at least bounded by a band-shapedfastening means running from the ipsilateral shoulder, around the frontof the trunk to the contralateral side of the trunk in the area of thepatient's waist, and around the back of the trunk to the ipsilateralshoulder, such that the band-shaped fastening means forms an acute anglerelative to a g-line, which is defined as a horizontal line runningbetween the armpits at the respective ipsilateral and contralateralsides of the trunk, and a boundary line running from the patient'sarmpit to the band-shaped fastening means, whereas the shoulder partexerts an approximately constant, adequate tissue pressure when in use.

A lengthened and widened shoulder part is known per se from GB-2242818.This British patent application describes protective garments, inparticular a protective garment for keeping the shoulder joint warm. Theknown garment comprises various types of elastic material with adiffering degrees of elasticity. The shoulder part thereof has undergonea special treatment, as a result of which it retains heat better.

The known protective garment with lengthened and widened shoulder partis entirely unsuitable for the object of the present invention, i.e. forthe treatment of hyperalgesia, in this case for consolidating andincreasing the beneficial effects of manual lymph drainage in therelevant abovementioned areas of the human body. The envisaged heateffect of the known garment in fact promotes the formation of oedema,and consequently of hyperalgesia. In addition, the known garment exertsan abruptly changing tissue pressure on the tissue, due to the use of acombination of materials with differing degrees of elasticity. On theother hand, the compression devices according to the present inventiontreats hyperalgesia by exerting an approximately constant pressurethrough the shoulder part thereof, whereas the remaining part comprisesan arm compression hose which preferably exerts a gradually decreasingtissue pressure as the length of the arm compression hose is traversedfrom the distal (i.e., hand and/or wrist) to the proximal (i.e., theshoulder end of the arm) end.

In a further embodiment the shoulder part is made wider at the front andback of the trunk of the patient. In this embodiment the compressionhose will slip little, if at all, after fastening, with the result thatpressure is exerted on the tissue at the correct points.

In a further embodiment the shoulder part is slightly preshaped. Thecompression hose according to this embodiment can advantageously beadapted to the anatomical shape of the trunk area of the particularpatient which runs between an h-line, a g-line, and the band shapedfastening device (mentioned above), as described further below, whenthis area of the patient and requires treatment.

In a further advantageous embodiment the compression hose is provided,at at least one place at the side next to the body, with a lining pocketfor the accommodation of a compression pad, in order to increase thelocal tissue pressure. In this embodiment the tissue pressure canadvantageously be increased further locally, in order to give optimumpain relief. The corresponding pressure change has a gradual course,viewed from distal to proximal, even when a compression pad according tothe invention is used. This compression hose is suitable in particularfor treating cases of severe hyperalgesia.

The present invention also relates to compression pants of elasticmaterial provided with legs, which in use at least partially cover theupper legs of a patient.

In practice, such compression pants of elastic material are known, forexample, cycle racing shorts.

The object of the invention is to make the known compression pantssuitable for local consolidation and/or increasing of the beneficialeffects of manual lymph drainage in the treatment of hyperalgesia in thearea to be covered by the compression pants.

To this end, the compression pants according to the invention arecharacterized in that, at at least one place at the side next to thebody, they are provided with a lining pocket for the accommodation of acompression pad, in order to increase the local tissue pressure.

The compression pants according to the invention make it possible alsoto exert an increased tissue pressure on congested or damaged lymphareas in, inter alia, the hip and/or abdomen area, the pubic area and/orthe groin area of the patient.

The present invention also relates to a compression pad for use in thecompression hose and/or the compression pants, in which the shape of thecompression pad is adapted to the anatomical shape of the place on thebody of the patient on which the compression pad exerts pressure when inuse. Such a compression pad provides a non-forcing pressure from theoutside on the congested and painful area concerned, with the resultthat the tissue pressure locally rises further, and the effect of theMLD is consolidated and/or increased, and recurrence of hyperalgesia iscounteracted when the MLD has ended.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be explained in greater detail with reference to thefigures, in which:

FIG. 1 shows a part of the human body, in which a number of lymphdrainage areas are indicated;

FIG. 2 shows a preferred embodiment of a compression hose according tothe present invention;

FIG. 3 shows a first preferred embodiment of compression pants accordingto the invention;

FIG. 4 shows a second preferred embodiment of compression pantsaccording to the invention;

FIGS. 5 to 14 show exemplary embodiments of compression pads for usewith the compression hose and/or the compression pants according to theinvention.

MODES FOR CARRYING OUT OF THE INVENTION

FIG. 1 shows a part of a human body 1 at the front, indicating a numberof lymph drainage areas and lymph nodes 2 to 4, on which the tissuepressure can be increased by means of the compression hose and/or thecompression pants according to the invention. The axillary lymph glandsnear the armpits are indicated by reference number 2. The lymph areasaround the groins are indicated by reference number 3. Reference number4 indicates the supraclavicular lymph areas and the neck lymph areas.Lymph gland dissection in the lymph drainage areas shown can be thecause of hyperalgesia occurring in the operated hemithorax and thecorresponding arm, and in the lower operated trunk area and thecorresponding leg.

FIG. 2 shows a preferred embodiment of an arm compression hose 10according to the present invention.

In the preferred embodiment, arm compression hose 10 comprisesband-shaped fastening means 11, which is fitted on shoulder part 12. Inan alternative embodiment, arm compression hose 10 is provided withfastening means for fastening the arm compression hose on a garment,such as a brassiere (not shown). Arm compression hose 10 also comprisesan arm part 13, and can be provided optionally with a hand part 14.

Depending on the symptoms, the shoulder part 12 can be widened orlengthened in the direction of certain painful areas on the trunk of thepatient. When axillary lymph nodes are removed in the area 2 (see FIG.1), the shoulder part 12 can be widened correspondingly in the directionof the armpit/armpit folds of the patient. The shoulder part 12 iswidened in such a way that when in use it covers at least an area on thetrunk which for the rest is bounded by band-shaped fastening means 11and a boundary line 16, running from the patient's armpit to band-shapedfastening means 11. The boundary line 16 is preferably situatedessentially at an angle α of between −45 and +45 degrees with the g-linerunning horizontally between the two armpits. More preferably, the widthof the shoulder part of the compression device according to theinvention is ≧10 cm.

When pain is being experienced in the area 4 (see FIG. 1) the shoulderpart 12 can be lengthened accordingly in the direction of the neck ofthe patient. The shoulder part is then lengthened according to theinvention in such a way that when in use it extends past the h-line,which runs vertically from the armpit to the shoulder line. In apreferred embodiment the shoulder part 12 extends at the most to thecurve of the neck, with the result that irritation from the fasteningmeans 11 in the patient's neck during wearing of the compression hose 10is effectively prevented.

The shoulder part 12 can also be slightly preshaped, so that it can beadapted in the optimum manner to the anatomical shape of the part of thetrunk running between the h-line and g-line, and band-shaped fasteningmeans 11 in the patient concerned.

Although FIG. 2 shows only a widening at the front, it willautomatically be clear to a person skilled in the art that the wideningcan also be applied at the back, in order to exert pressure on thecranial trunk areas.

The arm compression hose 10 is made of elastic material with apredetermined compression value. Said compression value is adapted tothe desired treatment. In practice, the compression values are brokendown into classes. An example of a classification commonly used inGermany is given below.

Class 1: 20-30 mm Hg

Class 2: 30-40 mm Hg

Class 3: 40-50 mm Hg

All compression values from classes 1, 2 and 3 are easily usable formedical treatments.

The compression value of the present arm compression hose falls mainlyin classes 2 and 3. The compression value thereby decreases from thewrist in the direction of the g-line. For example, assuming that thewrist compression value is 100%, then the compression value isapproximately 70% near the g-line. The arm compression hose according tothe invention preferably has a gradual change in compression value, from100% of the maximum pressure at the wrist and/or hand, to approximately70% of the maximum pressure at the shoulder end of the arm near theg-line, whereas the compression value of the shoulder part in thepreferred embodiment is essentially equal to the compression value nearthe g-line (i.e., approximately 70% of the maximum pressure). Thecompression in the lymph areas around the shoulder in this case isbrought about partly by adapting the shoulder part 12 to the anatomicalshape of the particular area of the patient's body and by pulling theband-shaped fastening means 11 sufficiently taut.

Shoulder part 12 is preferably widened both at the front and the back ofthe patient's trunk. The advantage of this is that the arm compressionhose 10 will slip little, if at all, when in use, with the result thatit is ensured that pressure is always applied in the correct place tothe tissue concerned.

The arm compression device according to the present invention can beused in the following indication areas:

1) hyperalgesia in general

2) hyperalgesia in the case of acute radiation reactions

3) palliative treatment of malignant lymph oedema

4) oedema formation

5) gland dissection

6) seroma formation

7) haematoma formation

8) infiltration

9) pasty fibrosis (soft fibrosing)

10) fibrosis

11) painful scars (adhesions, dehiscence, redness, itching), not only inthe operated hemithorax and the corresponding arm, but also in theoperated half of the lower trunk and the corresponding leg.

FIG. 3 shows a first preferred embodiment of compression pants 20according to the invention. Compression pants 20 have legs 21, each ofwhich is provided with a broad, supple cuff 22, preferably measuring 3to 5 cm, in order to prevent pinching. Compression pants 20 are made ofelastic material with a preferably essentially constant compressionvalue of class 1 to 3. In the preferred embodiment shown, compressionpants 20 are pre-eminently suitable for exerting pressure on theabdomen/hip area, the pubic area, the groin area and parts of thethighs. Depending on requirements, the legs of the compression pants canextend over the entire leg, including the foot, of the patient (notshown).

The compression pants according to the invention are provided at atleast one point at the side next to the body with a lining pocket (notshown) for the accommodation of a compression pad, in order to increasethe tissue pressure. This lining pocket is preferably made of thin,stretch material with few seams, and can either be knitted or sewn intothe pants. The lining pocket itself may be divided into variouscompartments, in which several compression pads can be inserted. The useof such a compression pad provides for non-forcing pressure from theoutside on an indication area, with the result that the tissue pressurerises further. It can be pointed out that the compression pantsaccording to the invention can also be used in the indication areas 1 to11 listed above as regards the part of the body which is covered by thecompression pants when they are in use, which is in particular thehip/abdomen area, the pubic area, the groin area, the legs and the feet.

In the preferred embodiment shown, compression pants 20 are providedwith a v-shaped compression pad 24 placed inside lining pocket 60 forthe pubic area and the lower abdomen/groin area.

FIG. 4 shows a second preferred embodiment of compression pantsaccording to the invention. Compression pants 20 are provided withcompression pad 26 for the hip/abdomen area of the right side of thepatient by use of lining pocket 60. Similarly, or in addition to, acompression pad may be inserted into pocket 60 for the left side of thepatient, or a single compression pad may entirely fill lining pocket 60.

In order to achieve optimum freedom of movement for the patient,separate compression pads will generally be provided for the legs. Tothis end, the compression pants according to the invention arepreferably provided with one or more corresponding separate liningpockets for the accommodation of the respective one or more compressionpads.

It can also be pointed out that compression pads 24 and 26 are shownonly at the front, but it will be clear that they can also extend to therear of the trunk where necessary.

It can also be pointed out that the compression pants can be madesuitable for osteoma patients by providing both the compression pantsand the compression pads to be accommodated therein with openings whichare adapted to the shape and location of the one or more osteomasconcerned including the use of a donut shaped pad or equivalent thereof(e.g., two or more partial donut shaped pads that, collectively, definea donut shape when placed appropriately end-to-end within a liningpocket therefore) placed about an osteoma opening/outlet.

A compression pad is preferably made of resilient material about 0.5-1cm thick, such as foam rubber, which is made with the edges flattenedoff or bevelled, and which is clad with, for example, a thin materialwith few or no seams. The delicate and careful treatment principle ofmanual lymph drainage is carried further in the finishing of thiscompression pad, which generally has a large surface area. Each thick orhard seam in the surface to be treated has a counterproductive effectand is therefore subject to high standards, in order to achieve thedesired objective.

The foam rubber of the compression pad in some cases is smooth at leaston one surface, and in other cases is provided with small grooves onsaid surface, as a result of which individual compression cushions areproduced. It is also possible to use individual cushions of resilientmaterial which, after fastening on said surface of the compression pad,can exert additional pressure on concavities in the area to be treated.These compression cushions are particularly suitable for treatment aftergland dissection and/or in the case of scars, where the latter can fullyor partially fill up the tissue cavity which has sometimes occurred.

The compression pad and the individual cushion can be made to measureand are accommodated in said lining pockets.

The shape and dimensions of each compression pad are adapted to theanatomical shape and dimensions of the place on the body where thecompression pad concerned is to exert pressure.

In order to increase local tissue pressure in the supraclavicular area,the shoulder area and the cranial trunk area, compression hose 10 canalso be provided with one or more lining pockets for the accommodationof compression pads and/or compression cushions of the type mentionedabove.

FIGS. 5 to 14 show further exemplary embodiments of compression pads foruse in the case of the compression hose and/or the compression pantsaccording to the invention.

In these figures:

30. is an anatomically shaped compression pad for adequate treatment ofthe supraclavicular area, the shoulder area and the cranial trunk area;

31. is an anatomically shaped compression pad for treatment of the upperarm;

32. is an anatomically shaped compression pad for treatment of the elbowarea;

33. is an anatomically shaped compression pad for treatment of the lowerarm and back of the hand;

36. is an anatomically shaped compression pad for treatment of the thighor upper leg;

37. is an anatomically shaped compression pad for treatment of the kneeand back of the knee;

39. is an anatomically shaped compression pad for treatment of foot andankle;

40. is an anatomically shaped compression pad for treatment of theankle.

Compression pads/cushions 30 to 33 are suitable for use in the armcompression hose and/or compression device according to the invention.Compression pads 36 and 37, 39 and 40 are suitable for use in thecompression pants according to the invention. When in use, a compressionpad is essentially covered by the compression hose or pants. Withrespect to FIG. 7, lining pocket 62 is shown for receiving one or morecompression pads/cushions.

In general, when compression pads are used in conjunction with an armcompression hose, a compression device, and/or compression pantsaccording to the invention, the total pressure on the arm or the leg isgreater distally than proximally, in order to make the lymph stream flowaway to the proximal discharge areas in the best way possible.

If desired, a compression panty hose can be worn over the short-leggedcompression pants, the compression value of said panty hose beingselected in such a way that the compression value increases from thethigh towards the foot. In this way shifting of the symptoms to thelower leg is prevented.

It can be pointed out that all compression pads can be provided with oneor more corresponding compression cushions. All compression pads can beproduced both as left-side and as right-side models. Each compressionpad can be provided with Velcro (see fastening elements 41-59 in FIGS. 8to 12) or other known fastening means, in order to hold the compressionpad in position.

It will automatically be clear to a person skilled in the art that thecompression pads can be adapted both in length and in width to the sizeof the body area to be treated, without departing from the idea of theinvention. For example, compression pad 36 can cover only the inner halfof the thigh if the patient's symptoms are limited to that area.

What is claimed is:
 1. A method of treating the symptoms of hyperalgesiacomprising: selecting a compression device comprising: an elasticmaterial, where said elastic material exerts pressure on at least aportion of an arm, a shoulder, and a trunk of a patient in need thereof,and where said elastic material further comprises an inner side and anouter side, where: the arm comprises a wrist, an elbow, and a shoulderend; the trunk comprises a front, a back, a side ipsilateral to the arm,a side contralateral to the arm, a waist, and respective ipsilateral andcontralateral arm pits; said elastic material further comprising: an armcompression hose for exerting pressure on at least a portion of the arm,where the arm compression hose is positionable to cover at least aportion of the arm, is sized and configured to extend from the wrist tothe shoulder end, and wherein the pressure gradually decreases from amaximum pressure at the wrist to a minimum pressure near the shoulderend; a shoulder part for exerting pressure on at least a portion of theshoulder and the trunk; and a fastening means fitted on the shoulderpart, extending diagonally from the shoulder part, and wrapping aroundthe patient from the side of the trunk ipsilateral to the arm to theside contralateral to the arm; applying and fitting the compressiondevice to the body of the patient, comprising: selecting the armcompression hose elastic material to provide: a maximum compressionvalue at the wrist from about 20 mm Hg to about 50 mm Hg; and a minimumcompression value at the shoulder end of approximately 70 percent of themaximum compression value; and tightening the fastening means so thatthe shoulder part exerts a tissue pressure of approximately 70 percentof the maximum compression value.